Friday, 20 July 2007

Medicine and the space odyssey

*Since writing this piece my understanding has changed and I now believe it contains fundamental flaws. Anyone who would like further clarification is welcome to e-mail me at hklaxnessat- yahoo.com*

Editorial

Medicine and the space odyssey

Bruce G. Charlton

Medical Hypotheses. 2006; 66: 687-688

Summary

Up to the mid-1960s, science and technology (including medicine) were generally regarded as exciting, beautiful and spiritually enthralling; and the space odyssey seemed a symbol of the optimistic future of humankind. The early seventies saw a growing disillusionment with space travel as part of a mood of cultural pessimism and anti-modernization – and this combined with a resurgence of therapeutic nihilism in medicine. But recent discussions of renewed space exploration and a Mars mission may be evidence of a changing zeitgeist, with Western culture moving towards a bolder and more optimistic attitude. The adventure of space travel, exploration and colonization could be seen as both a barometer of cultural optimism, and an enterprise which would feed-back into cultural optimism for many decades to come. Medical science could also be a beneficiary; since greater boldness and optimism would be likely to renew the goals of medicine to do positive good – as contrasted with the necessary, but relatively uninspiring, requirement to minimize risk and harm. In a modernizing society humankind needs to look outward as well as inward: we need a frontier, and we need to grow. A resurgent space odyssey may be the best way that this can be enacted.

***

To me, man’s first walk on the moon is the most important mythological event of the 20th century. Before everybody’s eyes, that one event transformed the fundamental basis for our view of the universe and ourselves within that universe. Joseph Campbell, speaking in 1973 [1].

As a child growing up in the early-1960s, I was part of that post-1945 pro-science and technology zeitgeist which reached its cultural zenith with the movie 2001: a space odyssey (1968) and then the Apollo moon landing (1969).

Space exploration seemed to be the deepest symbol of the optimistic future of humankind. I just took it for granted that by the year 2006 people would be orbiting the earth as a birthday joyride, taking lunar holidays, and that researchers would be operating from a base on Mars. Science and technology were fashionable, exciting, beautiful and indeed spiritually enthralling.

Medicine was an integral part of this mood. A golden age of therapeutic revolution had been in full swing since the 1930s, and major clinical breakthroughs were an almost monthly occurrence [2]. Research seemed a great adventure, and the general attitude was discovery-orientated, with what seems to us now very little emphasis on the potential for risks and harm.

The cultural turn in the UK came sometime between the ‘Swinging London’ of 1966 – with its plastic clothes and shiny modernism, and the hippy ‘summer of love’ of 1967 – with its turn towards ethnic styles, Eastern religions and the beginnings of that pessimistic, anti-modernization youth counter-culture which still dominates [3].

Since the early seventies, science and technology have been generally regarded as alienating, threatening – indeed perhaps actually destructive. The imminence or actuality of eco-disaster has been a staple of school education and mass media fiction for around three decades (growing from the ‘oil crisis’ of 1973). Cultural commentators have looked upon scientific optimists and space explorers as intellectually-shallow, lacking in ‘soul’ and dangerously-naïve.

Something similar also applies in medicine: against the undoubted improvements in clinical practice since the sixties there is a powerful counter-current of therapeutic nihilism and cynicism. Influential epidemiologists and social medicine academics purported to show that most therapies and technologies made little discernable difference to health [4] and [5]. For the past few decades many Westerners take their science and technology with a guilty grimace and a dread of the consequences; medicine has been through an era of regulation and audit rather than discovery and invention.

The 1970s and 80s backlash against space travel was understandable, and of course contained a considerable element of truth. Yet while cultural pessimism may be a valuable corrective, it is not a viable long-term possibility for modernizing societies [6]. The key movie for this paranoid mood was the superb Blade Runner (1982) with its amoral and totalitarian corporations, saturation advertising, space colonization driven by dishonest and exploitative capitalism, and techniques of anti-individual mind-manipulation. Public intellectuals looked-back nostalgically to simpler technologies, traditional religions, smaller-scale societies and coherent communities: the heroes were peasant villages or nomadic hunter gatherers, rather than astronauts and robots.

However, my sense is that the tide may now be turning and the zeitgeist beginning to change. Recent signs that the USA and other nations including the UK are considering a renewed effort at space exploration, aiming at a manned trip to Mars, can be read as signs that the Western culture is again moving towards a bolder and more optimistic attitude. I regard renewed space travel, exploration and colonization as both a barometer of cultural optimism, and an enterprise which would feed-back into greater cultural optimism for many decades to come.

While there are various scientific, and possibly economic, justifications for space exploration; my sense is that its main value is as an adventure for humankind – the greatest adventure.

I believe that humankind needs to look outward as well as inward: society needs a physical ‘frontier’ to push-back, individuals need new places to escape-to, and culture needs to grow in size as well as complexity.

If this happens, medical science would also, indirectly, be a beneficiary; since a cultural attitude of boldness and optimism would be likely to renew the goals of medicine to do positive good – as contrasted with the necessary, but relatively uninspiring, requirement to minimize risk and harm [7].

As shown in the quotation that introduced this editorial, the great mythology scholar Joseph Campbell often observed that the moon landing was a profound spiritual event – indeed the defining myth of our time. Certainly, it has not been that so far, and in this respect the past three decades have been a crashing disappointment for the cultural optimists of the mid-20th century. But there is still time. It seems increasingly plausible to hope that Campbell’s prediction will ultimately prove correct.